In less than a decade, a quiet revolution has taken hold in American postpartum care: the same medications reshaping how the world thinks about weight and metabolic disease are now reaching new mothers at a rate twenty-four times higher than just seven years ago. USC researchers, publishing in JAMA, have mapped this shift across more than a million births, revealing that the change is driven not by a single patient profile but by a widening circle of women — those with type 2 diabetes, gestational diabetes, and increasingly, obesity alone. The findings arrive ahead of the science needed to ful
Postpartum GLP-1 prescriptions surge 24-fold among U.S. women, driven by diabetes cases
One in six postpartum women with type 2 diabetes now receives a GLP-1 prescription
Mark
Why does the postpartum window matter so much for these prescriptions? Why not wait longer?
Mimi
Pregnancy and the months after it create metabolic stress—blood sugar control gets harder, weight management becomes urgent. Clinicians see a window where intervention might prevent type 2 diabetes, especially in women with gestational diabetes. But it's also a window where we know very little.
Luke
The study doesn't actually tell us whether these prescriptions prevent diabetes or improve outcomes. It just shows they're being written. That's an important distinction.
Mark
What about the women with no prior diagnosis who got one before starting the medication?
Mimi
That's the interesting part. They came in postpartum, probably concerned about weight or metabolic health, got evaluated, received a diagnosis, and then started treatment. It suggests the medication itself may be driving the diagnosis in some cases.
Luke
Or it suggests that postpartum is when women finally get screened for obesity and metabolic conditions they had all along. We don't know which.
Mark
And the breastfeeding question—how serious is that gap in the research?
Mimi
Serious enough that the lead researcher called it out explicitly. We don't have safety data. Millions of women are now taking these drugs while nursing, and we're essentially learning as we go.
Luke
Though to be fair, the data shows most women waited three months postpartum before starting, which does reduce early exposure. But yes, long-term breastfeeding safety is genuinely unknown.
Mark
Does this happen in other countries?
Mimi
Denmark shows similar rates, which is striking. It suggests this isn't just an American marketing phenomenon—it's a real clinical trend across healthcare systems.
Luke
Though we only have Denmark to compare to. We don't know if this is happening in Canada, the UK, or elsewhere. The picture is still incomplete.
Der Puls
- GLP-1 prescriptions among postpartum women have surged twenty-four-fold in seven years, transforming from a rare clinical choice into a near-routine one for certain diagnoses.
- Women with type 2 diabetes are at the leading edge — nearly one in six now receives a GLP-1 within six months of delivery, up from fewer than one in forty in 2018.
- The fastest-growing group is women with obesity or overweight, whose prescription rate nearly tripled in just the last three years and now accounts for four in ten postpartum GLP-1 users.
- Most prescriptions begin at least three months after delivery, suggesting clinical caution — but that caution rests on a foundation of limited evidence about the drugs' effects during breastfeeding.
- The study's blind spot is significant: Medicaid, which covers roughly four in ten U.S. births, was excluded, leaving the full national picture incomplete even as researchers call urgently for safety data.
In less than a decade, a quiet revolution has taken hold in American postpartum care: the same medications reshaping how the world thinks about weight and metabolic disease are now reaching new mothers at a rate twenty-four times higher than just seven years ago. USC researchers, publishing in JAMA, have mapped this shift across more than a million births, revealing that the change is driven not by a single patient profile but by a widening circle of women — those with type 2 diabetes, gestational diabetes, and increasingly, obesity alone. The findings arrive ahead of the science needed to fully understand them, as the safety of these drugs during breastfeeding remains an open and pressing question.
A study published October 1st in JAMA has documented a dramatic transformation in how American new mothers are being treated in the months after delivery. Analyzing private insurance claims from just over one million births between 2018 and early 2025, USC researchers found that GLP-1 prescriptions — the class of medications that includes Ozempic and Zepbound — have surged twenty-four-fold among postpartum women over that period. What began as a rare clinical event, affecting fewer than one in a thousand new mothers, now reaches nearly two in a hundred.
The growth has not been uniform. Women with type 2 diabetes have led the trend, with their prescription rate climbing from 2.3 percent to 16.9 percent — roughly one in six. Women who experienced gestational diabetes during pregnancy, a condition that raises lifetime risk for type 2 diabetes, saw their rates rise from under half a percent in mid-2021 to 2.7 percent by early 2025. The sharpest relative climb, however, belongs to women with obesity or overweight before pregnancy, whose rate nearly reached four percent by early 2025 after sitting below half a percent just three years prior.
The profile of who is receiving these prescriptions has also shifted. Since late 2024, women with obesity or overweight have made up four in ten postpartum GLP-1 users — a sign that metabolic concerns beyond diabetes are increasingly driving both diagnosis and treatment in the postpartum period. Most women begin the medication at least three months after delivery, a pattern that reflects clinical caution about early breastfeeding exposure.
Yet that caution exists within a significant knowledge gap. Lead researcher Sih-Ting Cai of the USC Schaeffer Center noted that evidence on GLP-1 safety during breastfeeding remains thin, even as postpartum initiation becomes increasingly common. The study's scope is also bounded by its data source: Medicaid, which covers roughly four in ten American births, was not included. Still, the privately insured U.S. rate closely mirrors figures from Denmark, suggesting this is a broader phenomenon rather than a quirk of the American system. Researchers and clinicians now face the task of catching the science up to a practice that is already well underway.
A new study from USC researchers has documented a striking shift in how American obstetricians are treating new mothers: prescriptions for GLP-1 medications—the diabetes and weight-loss drugs known by brand names like Ozempic and Zepbound—have surged twenty-four-fold among postpartum women over the past seven years. The finding, published October 1st in JAMA, offers the first detailed accounting of which women are driving this growth and raises questions about safety that remain unanswered.
The researchers analyzed private insurance claims covering just over one million births between 2018 and early 2025. In the first half of 2018, fewer than one in a thousand new mothers filled a GLP-1 prescription within six months of delivery. By the first quarter of 2025, that figure had climbed to nearly two in a hundred—a transformation that happened in less than a decade. The growth was not uniform across all postpartum women. Those with type 2 diabetes led the way: their prescription rate jumped from 2.3 percent to 16.9 percent, meaning roughly one in six women with this diagnosis now receives a GLP-1 in the months after birth.
Women who developed gestational diabetes during pregnancy—a temporary condition affecting five to nine percent of pregnancies and a known risk factor for later type 2 diabetes—also showed substantial increases. In mid-2021, less than half a percent of this group started a GLP-1 prescription. By early 2025, that had risen to 2.7 percent. The fastest relative growth, however, occurred among women diagnosed with obesity or overweight before pregnancy. Their prescription rate climbed from 0.4 percent in the second half of 2021 to 3.9 percent by early 2025—a nearly tenfold jump in just three years.
The composition of postpartum GLP-1 users has shifted noticeably in recent months. Since the second half of 2024, women with documented obesity or overweight have accounted for four in ten new prescriptions among postpartum women. Another one in five recipients had no documented qualifying diagnosis before pregnancy, though most of these women received a diagnosis—typically obesity or overweight—before starting the medication. This pattern suggests that postpartum weight and metabolic concerns are increasingly prompting both diagnosis and treatment.
The timing of these prescriptions appears cautious. Patients are instructed to discontinue GLP-1 use during pregnancy, and the data shows that most postpartum women who started the medication did so at least three months after delivery, reducing the window of potential exposure during early breastfeeding. Yet this caution exists in a knowledge gap. The lead researcher, Sih-Ting Cai of the USC Schaeffer Center for Health Policy & Economics, noted that evidence on GLP-1 safety during breastfeeding remains limited, and the rapid expansion of postpartum use demands further investigation.
One important limitation shapes how to read these findings: the study examined only private insurance claims and excluded Medicaid, which covers roughly four in ten American births. The postpartum GLP-1 prescription rate among privately insured American women, however, closely mirrors the rate documented in Denmark, suggesting the phenomenon is not unique to the U.S. healthcare system. As these medications become more common in the months after delivery, researchers and clinicians face an urgent need to understand their long-term effects on mothers and nursing infants.
Bemerkenswerte Zitate
Postpartum is a critical window for addressing metabolic risk after pregnancy, and we're seeing GLP-1 use explode in this population. Because evidence on GLP-1 exposure during breastfeeding remains limited, rising postpartum initiation warrants further study.— Sih-Ting Cai, lead researcher, USC Schaeffer Center for Health Policy & Economics
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